Living across the country from my family, I have loved the new technologies that allow us to stay in touch.  Using Skype or Face-time, in between visits home, I am able to see my nephews as they learn to walk, talk and recite the ABCs.  Last year, during one such online exchange, my nephew pointed to my face on the screen and said, “Aunt Audrey!”  He then climbed up onto the desk, obscuring my view as his body pressed against the computer’s camera.   When I asked what he was up to, my sister informed he that was looking for me behind the computer!

As a pediatrician, I see hand-held computer and mobile devices in the hands of an ever-younger population and I can’t help but wonder what kind of effect the rapid advances in technology are having on these developing minds.  Are the lessons of object permanence changing for my nephew as he is able to interact with a virtual “Aunt Audrey?”

Certainly, technologic advances are amazing and are doing wonderful things for the advancement of society, but I just can’t help but get the sense that we are pushing ever closer to a brave new world.  The YouTube video showing a toddler sliding his index finger across a magazine page – trying to change the image as you would on any number of touch-pad devices- is cute on the surface.  But it becomes somewhat disconcerting when I think about what lessons this child is learning about how to interact with his environment.

Admittedly, hand-held computer devices have made the pediatrician’s job easier!  To quiet an upset child, all a parent needs is their cell-phone uploaded with Dora the Explorer and – voila! – the physical exam is over in a cinch.   Nowadays computers are at the center of medicine, business, communication… life.   How are our brains changing as we lose touch with the tangible world and lose ourselves in the virtual?

Growing up, I had my fair share of “screen-time,” playing Klondike, Duck Hunt and Where in the World is Carmen San Diego on my parents’ desktop computer.  But still, the vast majority of the time, I spent playing outdoors in the tree-house, in the sandbox or riding my bike.  I spent entire afternoons playing imaginary games with my sister and brother.  We dressed in costumes and put on shows.  We played on the porch and pretended it was a ship, lost out at sea.   Perhaps I am simply feeling nostalgic.

It’s likely that these newer versions of “screen time” are no less dangerous or harmful than their predecessors: the radio, TV, computer and video game console.  As with all things, moderation is the key.  As a pediatrician, I counsel families that children should have no more that 2 hours of total “screen time” per day.  What rules do you have about technology in your family?  I’d love to hear your thoughts below!

Living across the country from my family, I have loved the new technologies that allow us to stay in touch.  Using Skype or Face-time, in between visits home, I am able to see my nephews as they learn to walk, talk and recite the ABCs.  Last year, during one such online exchange, my nephew pointed to my face on the screen and said, “Aunt Audrey!”  He then climbed up onto the desk, obscuring my view as his body pressed against the computer’s camera.   When I asked what he was up to, my sister informed he that was looking for me behind the computer!

As a pediatrician, I see hand-held computer and mobile devices in the hands of an ever-younger population and I can’t help but wonder what kind of effect the rapid advances in technology are having on these developing minds.  Are the lessons of object permanence changing for my nephew as he is able to interact with a virtual “Aunt Audrey?”

Certainly, technologic advances are amazing and are doing wonderful things for the advancement of society, but I just can’t help but get the sense that we are pushing ever closer to a brave new world.  The YouTube video showing a toddler sliding his index finger across a magazine page – trying to change the image as you would on any number of touch-pad devices- is cute on the surface.  But it becomes somewhat disconcerting when I think about what lessons this child is learning about how to interact with his environment.

Admittedly, hand-held computer devices have made the pediatrician’s job easier!  To quiet an upset child, all a parent needs is their cell-phone uploaded with Dora the Explorer and – voila! – the physical exam is over in a cinch.   Nowadays computers are at the center of medicine, business, communication… life.   How are our brains changing as we lose touch with the tangible world and lose ourselves in the virtual?

Growing up, I had my fair share of “screen-time,” playing Klondike, Duck Hunt and Where in the World is Carmen San Diego on my parents’ desktop computer.  But still, the vast majority of the time, I spent playing outdoors in the tree-house, in the sandbox or riding my bike.  I spent entire afternoons playing imaginary games with my sister and brother.  We dressed in costumes and put on shows.  We played on the porch and pretended it was a ship, lost out at sea.   Perhaps I am simply feeling nostalgic.

It’s likely that these newer versions of “screen time” are no less dangerous or harmful than their predecessors: the radio, TV, computer and video game console.  As with all things, moderation is the key.  As a pediatrician, I counsel families that children should have no more that 2 hours of total “screen time” per day.  What rules do you have about technology in your family?  I’d love to hear your thoughts below!

I became hooked on caffeine in junior high.  One summer, I realized that without a morning glass of tea, I would have a headache by mid-morning.  Yesterday, I spoke about our nation’s obsession with caffeinated and sweetened beverages.  Why are young people turning ever more predictably to these coffee-drinks?  Is it even something we need to be concerned about?

Lets start with the most obvious benefit of coffee: caffeine.  As we all know, caffeine acts as a stimulant, improving concentration and increasing alertness.   Coffee’s origins date back as far as the ninth century, but it wasn’t until the 1800s that caffeine, itself, was isolated and identified as the magic component giving coffee its stimulating effects.    Unfortunately, tolerance to caffeine can develop rather quickly.  And too much of a good thing can mean tremors, restlessness, anxiety or insomnia.  Trying to quit caffeine?  You might find yourself in withdrawl, with headaches, fatigue, difficulty concentrating or even depressed mood.  In general, though, there is no good data to say that caffeine in moderation is really “bad” for you.

Which leads us to the second component of most of these caffeinated drinks: sugar.  Like soda and juice, the sugar content in one beverage can be astounding.  In my favorite go-to drink, a medium nonfat vanilla latte, I discovered there are 35 grams of sugar – that’s about 8 teaspoons!  The news is worse for my innocent milk tea.  In one serving there are 52 grams of sugar, totaling 13 teaspoons.  Now what about one of the large frozen mocha-flavored drinks topped with whipped cream and chocolate flavored drizzle – the ones similar to what I witnessed those school-aged children drinking?   Well folks, 87 grams.  That’s about 22 teaspoons of straight sugar!

With numbers like these you begin to see why these drinks might not be such a good idea after all.  Sugar not only leads to tooth decay, as our mothers warned us.  Sugar also leads to plaque build up in arteries and insulin resistance, putting us at risk for heart disease and diabetes.   In addition to juice and soda, these drinks need more recognition as being active players in our nation’s slide into obesity.

Do you have a rule about coffee or tea drinks in your house?  What kinds of healthy options can we start offering our young teens?  I’d love to hear your thoughts and comments!  Plus, put your favorite drink to the test.  To give nutrition facts more meaning, divide the grams of sugar on the nutrition label by 4 in order to get the number of teaspoons of sugar in one serving.  You might be surprised.

As I recently sat working at my computer in a nearby cafe, Earl grey milk tea in hand, I watched as a group of students walked past the window, all dressed in variations of the same school uniform.   A local school was letting out.  A few moments later, another wave of students walked by.  As the third group began to float past the window one-by-one, my eyes narrowed in on something.  Coffee cups.   I realized many of these fifty or so school children had been holding on to take-out coffee cups.   It struck me at once: what are these young people doing drinking coffee?

As a budding pediatrician, I have known to vilify soft drinks and juices as being a great contributor to our nations’ obesity epidemic, each containing about ten teaspoons of sugar per serving.  What about coffee?   Certainly these coffee drinks contain sugar, not to mention a significant amount of caffeine.  Why had I not been counseling on coffee drinks?

I tried to think back to a time before I drank caffeinated beverages.  I remember my mother’s cup of tea, an ever-present fixture at her office desk.  When I asked about it as a child she would say, “Oh, no.  You wouldn’t like it.  It is for grown-ups.”  That answer satisfied me until about junior high – the age of the throngs of students I mentioned earlier – when I tried my first glass of sweetened ice-tea.  Add sugar to anything, and a child will like it.  Sweet tea became my drink of choice.

It wasn’t until my final year of college that I really drank coffee.  And, of course, it wasn’t really coffee.  It was a mocha – a sickly sweet concoction of sugar and caffeine, desperately needed to fuel a late-night physics cram session.  After that, I was hooked.  Now, in my last year of residency, in addition to my morning cup of tea, I still look forward to treating myself to an occasional latte or a milk tea in the afternoon, as a treat on an especially rough day.

When did our nation’s fixation with coffee and caffeinated beverages begin?  And when did children become so transfixed?  It’s not just plain coffee, mind you, (again: add sugar, and children will like anything) it is the wide assortment of caffeinated and sugar-laden drinks available to our nation’s children: milk tea, energy drinks, lattes, cappuncinos, mochas, frozen mochachinos!   Should we see these drinks as a problem?  And why are they so darn habit-forming?

We explore these questions more tomorrow…

As a pediatric resident, I have families come into clinic on a daily basis with questions about parenting.  How do I discipline my child?  How do I get them to eat their vegetables?  How do I get them to stay in their own bed at night?   My question is: where does it say in the pediatric texts how to advise on parenting skills?  The truth: it often doesn’t!

As a doctor-in-training, the books tell us the what-you-need-to-do part of the equation, but leave the how-to-do-it part up for interpretation.  For example, the texts will tell you, a toddler needs to give up the bottle by 18 months, but it fails to say how you convince a child to do so.   It seems that effective pediatricians must have real-life inspiration to draw from.  Some ask their patients parents what has worked for them.  Others have their own child-rearing experience to draw from.  As for me, I rely on my sister.

My sister has two adorable boys – Finn and Oscar.  As the first grandchildren in our family, it hasn’t taken much effort on their part to stay in the spotlight.   As the eldest, Oscar was first to arrive on the scene, and he has certainly left an impression.  He is what you might kindly call “spirited” or “willful”.  But where euphemisms end comes the difficult truth: He has been one hard child to parent.

Oscar, like so many children, hasn’t followed the books.   He refuses to sit in a seat.  He laughs during a time-out.  He climbs high onto furniture and then throws himself off, laughing hysterically.   He pretends to kiss baby Finn and bites him instead.  He literally runs circles around us, as the rest of the family sits together having a family picnic.

As Oscar has hit every stage of development, I’ve found that my stock advice as a pediatrician has failed to hold up to the task.  Now, I don’t want to give the wrong impression: my sister has not asked for any advice in parenting from me, a non-parent.  I have merely heard her relay stories of failed efforts using tips I’m sure I’ve offered to many of my patients’ families.

Figuring out the right way to parent Oscar has been a challenge for my sister and her husband.  But the trials and tribulations of being a parent have won them the wisdom that comes with experience, and an arsenal of parenting expertise.  As Oscar enters his third year of life, he has mellowed a bit.  He is no longer waging a private war against his younger brother Finn, and his dare-devil acrobatics have ceased – at least for the time being.   He is learning to drink from a cup at mealtimes, and is finally enjoying his fruits and veggies.  As a mother to none, but an Auntie to two, I have had the benefit of learning from the tough experiences, without having to struggle through the lessons.  From my sister’s hard-won parenting battles, I now have a bit of real-life parenting to draw from, until I have the fortune of going through the lessons myself.